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Pumping for sick baby...having troubles

First, thank you - I've been reading here since my 10 wk old was born and have learned a lot. I need to ask for some help on a topic I haven't seen yet.

I'm a FTM. My baby has been EBF since we left the hospital (he was given some formula after pumped colostrum the day he was under the lights for jaundice), with a bottle of expressed milk about one feeding per week since wk 4. We had a rough start with soreness and shallow latch but we got help and things improved.

He usually takes one side per feeding. Sometimes he gets fussy at the breast maybe 7-ish minutes in. I thought it was due to the flow slowing and have had luck switching sides (read that here ). The last week or so I would say that happens more often. Also the last week he has started to sleep one 4-hr stretch at night. The rest of the night he wants to eat every 1.5-2hr on average. He also typically asks for more feedings in the evening, sometimes an hr apart.

Baby developed a wet cough and a rasp last night and the pedi had me bring him in today. His lungs are clear right now but she said a lot of RSV is going around and to watch him closely. They also weighed him and didn't seem concerned about it but he's only gained about a half oz per day the last 10 days (he was in then for 2-mo shots). Before that he'd been steady (after a slow start) at 7oz/wk.

Tonight he didn't stay at the breast long but still seemed hungry. We thought it might be congestion (he's not snotty yet so we can't suction)...after some effort, DH was able to give him about 2 oz of milk that I pumped this morning and he seems satisfied.

I felt that I "missed" this feeding because baby didn't take much and I wanted to protect supply and prepare in case baby can't/won't nurse overnight so I went to pump (Medela freestyle) and I only got about a half oz from one side (the one he nursed from) and 1.5 from the other.

I'm worried bc I'm putting together the weight gain slowing, the having to switch sides to finish a feeding, and this pumping output and wondering if I'm starting to have a supply problem? I don't know why that would be but I'm a little scared. Have I done something wrong? If so can I fix it?

I want to make sure he's getting enough especially since he's sick and needs to stay hydrated, and I want to get whatever antibodies I can in there to help him. I really hope I'm overreacting!

Thank you for any thoughts you can offer. This forum has really been a life saving resource for me and I appreciate it very much.

Re: Pumping for sick baby...having troub

We are sick, too, and I definitely feel ya on the congestion and nursing woes. I've been trying to just offer a lot more often, especially if it seems like the baby has only eaten for a very short time. Have you tried keeping the baby pretty upright while you nurse him to help with his congestion? I'm gonna try to describe how I do this, but I'm not sure I'll be able to put it into words, basically I sometimes have good luck holding the baby with his tummy against mine, with one arm between his legs and going up his back and sorta tucking my hand underneath his lower armpit; and my arm on the side I'm nursing on sorta keeping the head supported and the hand holding up his bottom. (My baby likes to eat while walking around the house, so I am doing this all while standing, so he's almost vertical). Of course you can also nurse more upright sitting down or side-lying, and laid-back positioning is pretty good for this (and a zillion other things), too.

As far as the dehydration goes, I feel that little soft spot on the top of the baby's skull, and if it's really hollow feeling, I take that as a sign that I should offer again, even if he isn't necessarily asking. And if it's really flush with the hard part of the skull, I figure he's pretty hydrated. Of course if he's hungry, I feed him regardless, but it helps me estimate his thirstiness, if that makes sense. Someone please correct me if this is totally erroneous thinking, since I kinda just made it up.

I don't really have much advice to offer on the pumping or supply, but I think that what you are pumping sounds like it's in the range of normal. The pump is not as effective as the baby at removing milk, so the best thing to do to keep up your supply and to make sure the baby is getting enough is to nurse often. If you're worried about weight gain, check the number of wet and dirty diapers.

Re: Pumping for sick baby...having troub

And don't be freaked out that you have to switch sides to fill baby up. Many- maybe even most- moms start put with some degree of oversupply. Often this means a baby needs only one breast per feeding. But if a mom feeds on demand and doesn't pump, the oversupply eventually goes away. At that point, she may need to start offering both breasts at a feeding, and she see her pump output decrease. The 2 oz you pumped the other night is a very normal amount to produce: most women with supplies that are well-matched to baby's need produce about 1.5 oz per hour. And remember, the baby can almost always get more milk out than the pump can!